HomeMy WebLinkAbout07030078 Application
City of Carmel/Clay Township Permit #: Of 03 ocn~
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Town Home, 8< Two Family: New Structures, Additions, Remodels, 8< Accessory Structures
BUILDER
OF
RECORD:
PROPERTY
OWNER:
LOCATION
8< PROJECT
INFO:
SEWER UTILITY
PROVIDER:
NAME: {\ 0
u/E'c..'? s oJ (5 +,,, <-
STREET ADDRESS: Ci
L{ ZZ W, 1G
c/)
BUILDER'S EMAIL ADDRESS:
0: dc. 01-, +/I'ltt, ''''1
~plA) c; I kr
I C+-
LOT #:
SUBDIVISION NAME:
f'i
c+-
WATER UTlUTY
PROVIDER:
FAX:
PHONE: l({ 1- 8510
CITYTi\d I s ST~
t()I~1?)1
ZIP:
L +; Zb8-
PHONE:
. c.. v.,
~73 . \b~3
STATE:
rJ
ZIP:
l-{ {,07
FAX:
SECTION:
ZONING:
~
SQUARE U-/
FOOTAGE: ,
ESTIMATED COST OF CONSTRumON:
(EXCLUDING LAND VALUE)
NAME OF UTILITY EXCAVATION CONTRACTOR; PlAN COMMISSION I BZA I BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT #'S (IF APPLICABLE):
FLOOD ZONE AREA DESIGNATION(S)
FOR THIS PROPERTY:
TYPE OF CONSTRUCTION:
o SINGLE FAMILY
o TOWN HOME
o TWO FAMILY
# of units being
constructed at this
time:
o RESIDENTIAL (For
Additions, Remodels. Etc.)
PROJECT INFORMATION:
Early Release
Permit:
Lot Split:
yX N
Y.>\N
TYPE OF IMPROVEMENT:
o NEW STRUCTURE
o ROOM ADDITION(S)
o PORCH ADDmON(S)
K DECK ADDmON(S)
o REMODEL
_ Basement Finish only
o ACCESSORY BUILDING
o DETACHED GARAGE
o ATTACHED GARAGE
o DEMOLITION
Manufactured
Trusses:
Sump Pump:
_Y 'X N
_yKN
Plumber's Indiana State License #:
f'jf\
Which plumbing codes will be applied to the construction:
,
o International Residential Code wjIndiana Amendments
o Uniform Plumbing Code wi Indiana Amendments
FOUNDATION TYPE: (Check all that apply for the new
construction area)
o CRAWLSPACE 0 POST &2(. BEAM _PIER
o SLAB 0 BASEMENT (WALKOUT:_Y_N )
For Single Family and Two Family dwellings, additions. remodels. and/or accessory structures, this pennit is valid only if constrUction commences within 180
days of the date of issuance of the building pennit, and must be completed (Certificate of Occupancy issued) within 18 months of the issuance date. Class I
structure pennits are subject to the General Administrative Rules of the State of Indiana (See 675 lAC 12) regarding expiration time frames for beginning and
completing construction.
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteration of a structure, or any change in the use of land or structures
requested by this application will comply with, and conform to, all applicable laws of the State of Indiana, and the ~Zoning Ordinance of Carmel Indiana -1993" (Z'
289) and amendments, adopted under authority of l.c. 36-7 et seq, General Assembly of the State of Indiana, and all Acts amendatory thereto. I further certify that only
kitchen, bath, and floor drains are connected to the sanitary sewer. I further certify that the construction will not be used or occupied until a Certificate of
Occupancy' issued by the Department of Community Services, Cannel, Indiana.
. <; fZ /?'ookr- '?J1- 07
Signa re of Owner or Authorized Agent Print Date
OFFICE USE ONLY: ***.*****************
~;II z..-- !. .Foot. '?>.~
=\<>S~. INSPECTIONS REQUIRED:
(Q;per FOO~ Lower Footing Unde
Rough In
R .
Meter Base
***********************************************
Fees:
Inspections:
/// (}O
~3 ,~O
# Charged Re-
Reviews
r;-o Additi~~(~
order J
I$U€l-I
3hl()1